Marijuana Consumption Patterns Among Frequent Consumers in Montevideo1

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Marijuana Consumption Patterns Among Frequent Consumers in Montevideo1 Marijuana Consumption Patterns among Frequent Consumers in Montevideo1 Paper to be presented at the 9th Conference of the International Society for the Study of Drug Policy (ISSDP) Ghent, Belgium. May 19-22, 2015 Dr. Maria Fernanda Boidi Insights Research and Consulting Montevideo, Uruguay [email protected] Dr. Rosario Queirolo Universidad Católica del Uruguay Montevideo, Uruguay [email protected] Dr. José Miguel Cruz Latin American and Caribbean Center, Florida International University Miami, Florida, United States [email protected] 1 The authors wish to express their gratitude to Florida International University, Universidad Católica del Uruguay and the Open Society Foundations whose joint efforts funded data collection for this project, and have led to the creation of the Latin American Marijuana Research Initiative (LAMRI). Special thanks go to Héctor Suárez and Jessica Ramírez, from the Observatorio Uruguayo de Drogas; Gustavo Robaina and the team of Pro-Derechos; Liesl Picard from LACC, Brad Hittle, Beau Kilmer and Peter Reuter. Finally, a huge thanks goes to the Red de Usuarios de Drogas, and especially to Milagros, for opening her house and network to our project. The final responsibility is, of course, solely ours. 1 Abstract Background: In 2013, Uruguay became the first country in fully regulating the marijuana market that now operates under state control. Marijuana can be legally acquired in three ways: self-cultivation, Cannabis club membership, and purchase in pharmacies (not yet implemented), and users need to enter a confidential registry to gain access. Methods: This article presents the results of a Respondent Driven Sample survey of 294 high-frequency marijuana consumers that live in Montevideo and the metropolitan area. Results: Frequent consumers started experimenting with marijuana long before achieving the legal age to do it, with the mean age of first experience being lower for the youngest. Frequent consumers resort to more than one method for acquiring marijuana, with undisputable predominance of illegal means of access. Marijuana users overwhelmingly support the current regulation, but a big proportion of them are reluctant to register. Conclusions: Some of the attitudes and behaviors of the high-frequency consumers might posit a challenge to the success of the marijuana law. Individuals relying in more than one method of access defy the unique way of access clause that is a prerequisite to legal access. Reluctance to enter the register by a big proportion of high-frequency consumers generates doubts about the law being able to achieve its objectives if it fails to embrace most consumers under the registry. 2 Introduction In 2013, Uruguay became the first country in the world to regulate the possession, growth, and distribution of Cannabis. The initiative of marijuana regulation by the then president José Mujica, was passed by the Uruguayan Congress and signed into Law as 19,172 by the President in December 20, 2013. Law 19,172 provides three ways to legally obtain Cannabis in Uruguay: through self-cultivation, by participating in Cannabis clubs, or by directly purchasing marijuana at a pharmacy. Individuals must become registered users before the IRCCA, the Instituto de Regulación y Control del Cannabis (or Cannabis Control and Regulation Institute). Currently, the channels of access to marijuana are mutually exclusive: individuals must select only one way to (legally) obtain marijuana. The regulation establishes that a maximum amount of 40 grams of marijuana per month per user will be distributed. The new marijuana policy is still under implementation. The registry for self- cultivators has been completed and the process for the registration of Cannabis clubs is under way; about 15 clubs are in the process of obtaining approval for IRCCA at the moment (but none has gotten it yet). Sales through pharmacies have been deferred several times, likely due to the complexity of its implementation (which required, among other tasks, an open call for companies interested in cultivating marijuana for this purpose). The IRCCA has not made public its decision regarding how many companies (nor which ones) will be in charge of the cultivation. Many aspects of the marijuana regulation policy implementation and the regulations that come with them are still being drafted. 3 The innovative drug policy approach in which Uruguay has embarked has been met with great enthusiasm by the civil movements that had long claimed for legal marijuana in Uruguay2 and that had been a key part of the current policy design (Garat 2015). The regulation of marijuana, however, has been also met with important challenges. According to the AmericasBarometer 2014, over sixty percent of Uruguayan citizens have expressed disagreement with the law (Boidi, Queirolo, and Cruz 2015). Additionally, leaders within the International Narcotics Control Board have expressed opposition to legalization, characterizing the new law as being in direct defiance of the international drug control treaties.3 As a result, Uruguay faces both domestic and international opposition in pursuing its innovative marijuana regulation model. In this context, the Latin American Marijuana Research Initiative (LAMRI) is conducting a series of studies about different aspects of the new drug policy environment in Uruguay.4 This article focuses in one of our most recent studies: a Respondent Driven Sample (RDS) survey of frequent marijuana consumers in Montevideo and the Montevideo metropolitan area. The main aim of this research is to describe the attitudes and behaviors of the recurrent marijuana users, especially in light of the new regulations. Frequent marijuana consumers (those who use marijuana at least once a week) were asked about their first experiences with marijuana, as well as their 2 It is worth mentioning that consumption of marijuana has been legal in Uruguay since 1974, according to Law 14,294. However, the acquisition of the substance remained illegal, which was source of concern for consumers that needed to violate the law to incur in a behavior that was legal. This led to judicial insecurity, with police officers and ultimately judges having great discretion over penalization for users. See Garat 2015 for more details. 3 http://www.newsweek.com/un-says-us-marijuana-legalization-violates-international-law-283912 4 LAMRI was born with the objective of monitoring the regulation process of the Cannabis market in Uruguay, as well as the ongoing debate and developments on the issue that are taking place across the Americas. As indicated by its name, this is an academic endeavor; its ultimate goal is to collect, analyze, and widely distribute data on marijuana policy that was obtained and analyzed following strict quality standards. LAMRI is formed by the Latin American and Caribbean Center (LACC) at Florida International University, Universidad Católica del Uruguay, and Insights Research and Consulting. 4 current consumption patterns. Ways of accessing marijuana and forms in which marijuana was consumed were explored, as well as their attitudes towards the marijuana regulation law. The exercise of collecting this information at this early stage in the new marijuana policy implementation is a crucial enterprise because it constitutes the baseline for policy impact evaluation. At the same time, it can inform the policy process as it unfolds. In light of this, the main purpose of this article is to introduce the study of frequent consumers of marijuana as well as to present preliminary findings that might be useful to delineate imminent action in the policy implementation. Henceforth, this is essentially a descriptive piece, with the primary objective of disseminating preliminary findings aiming at starting a scholarly and public discussion about them. The following section focuses on the data and methods, with special attention to the specifics of the RDS methodology and the description of the sample. Next, first experiences with marijuana are discussed, as well as current consumption patterns, with a special focus on ways of acquiring marijuana. The subsequent section is devoted to the analysis of frequent consumers’ attitudes towards the marijuana regulation. The final section recaps in the main findings and its implications for the current efforts in policy implementation. Data and Methods Our research team conducted a Respondent Driven Sample (RDS) study of frequent marijuana consumers, residents of Montevideo and the metropolitan area, in Uruguay. The target population was defined as individuals of age 18 or more, who live in the Montevideo metropolitan area and that consume marijuana at least once a week. 5 One of the requirements of the RDS methodology is for the individuals studied to form a social network and to interact face to face (in order to allow recruitment of new participants). Therefore, the study needed to be geographically circumscribed to allow for this interaction among participants. Montevideo occupies a small area (530 square kilometers) (COMM 2014), but the metropolitan area but hosts more than 1,6 million inhabitants, roughly half the entire population of the country (Instituto Nacional de Estadística 2012). For all those reasons, Montevideo and its area of influence was the location of choice for the investigation. This is a study of frequent consumers only and therefore not representative of all marijuana consumers. Evidence from various studies points to the fact that frequent consumers account for
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